Provider Demographics
NPI:1487830162
Name:MINOCCHI, DONALD DEAN JR (LPN)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:DEAN
Last Name:MINOCCHI
Suffix:JR
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8462
Mailing Address - Country:US
Mailing Address - Phone:386-673-6474
Mailing Address - Fax:
Practice Address - Street 1:51 S CENTER ST
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8462
Practice Address - Country:US
Practice Address - Phone:386-673-6474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-13
Last Update Date:2008-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5164754164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse